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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: 9/3012019 Permit Number:
SCANNED
BY RFc
St. Lucie County sFo 'Teo
Building Permit ApplicationpP"'•�'�9 ��1piy
Planning and Development
and de Regulation ��
Division co
Bo�� 0171.
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:"
Address: 12790 NW MARINER COURT
Commercial Residential XXX
Property Tax ID #: 4425-603-0036-000-9
Site Plan Name:
Project Name: MARINER VILLAGE HARBOUR RIDGE -PLAT 4- UNIT 24
DETAILED DESCRIPTION OF WORK:
BUILDING SCREEN ENCLOSURE
CONSTRUCTIONINFORMATION:.
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing G/ _S rinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: / Sq. Ft. of First Floor:
Cost of Construction:$ 18700.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE>
CONTRACTOR: '
Name MARK $ KATHY WITACZACK
Name:MARIO RUSSO
Address-12790 NW MARINER COURT
Company, MARIO RUSSO ALUMINUM INC
City: PALM CITY State: _
Zip Code: 34990 Fax:
Phone No.913-991-2400
Address:291 SW DUVAL AVE
City: PORT ST. LUCIE State: FL
Zip Code: 34983 Fax:
Phone No772-370-8671
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail russocustomfloo(ng@yahoo.com
State or County License30367
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
OL
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB BEF E THE FIRST INSPECTION. UT YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LEI11D AN RNEY BEFORE RECORDING YOUR NOTICE OF C MMENC "
ev.
SUPPLEMENTAL`CONSTRUCTION LIEN,LAW INF,ORM/1TION �
DESIGNER/ENGINEER:
Name: rcoRion,uun+wuM Q,e�No=a�Nc
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address: sago wJaese sr sure, io
Address:
City: TEA
Zip: sssss Phones+sarasaoa
State: �
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _Not
Name:
Applicable
BONDING COMPANY: _Not
Name:
Applicable
Address:
Address:
City:
City:
Zip:. Phone:
Zip: Phone:
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
Th or oing instrument was acknowledged before me
The forgoing instrui ent was acknowledged before me
this_day of 20�by
this_jj�K 20 by
Name of person ma ong st tement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Produced
Type of Identification
Produced
,.�"@'�;�.,, ELLEN VAUGHN
(Signature of,_rSfSta�dfffNr(eJq GHN -
(Signature
`'��''c �� o�•�` My CtlmRi1961F7F Ex ues
9atober 11
ate of Florida-
=y •, Co Notary public
-� #(�gai]'0079
Commission
Commission N •,o�?,° Mmmission
ommission Expires
-
- 9etebyr 2p, 20;?2
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